Complications of removal of indwelling pleural catheters.

We read with interest the article published by Fysh et al 1 in CHEST (April 2012) describing a high incidence (10%) of fractured, indwelling, pleural catheters (IPCs) and would like to comment on the much lower incidence of this complication as it is reported in the literature and in our experience with IPCs. Our review of seven publications on the subject, including a systemic review by Van Meter et al 2 comprising almost 2,000 IPCs, described only one case of a fractured IPC in a patient with mesothelioma and trapped lung. 3 In a review of our institutional database, we identifi ed only two fractured catheters out of 1,790 IPCs that we placed since 1998. While the cause of this signifi cant discrepancy in the rate of catheter fracture between the authors’ experience and ours is unclear, we would like to highlight several factors that could contribute to the variance: